Sunday, April 5, 2009

Healthcare for Elders in France

THIS WAS DONE BY JENNIFER NICHOLS!
In speaking to the elderly and family needs for who is responsible to care for them, I feel like our society has changed its views dramatically over the past few generations. It used to be a given that once your parents were old enough to need help of some sort, whether it be because of sickness or old age, that the children would take on the care giving role, usually the daughter if there was one. This usually required the child to give up their plans and focus on the parent or elderly family member, or to play and impossible game of juggling a personal life and family of their own, while still caring for the other family member. However, with the growing popularity of elderly homes and places where these members of our families can go and be cared for and kept healthy while still being able to be visited, it seems to be the best of both worlds. In our fast paced and individualistic society it seems that we must do whats best for us, and changing plans according to our parents is not in the script.

Caring for the Elderly

We decided to focus on the care of the elderly (our cut off point is 60 years old). We chose four countries: United States, India, England and France. Each country has very different policies and expectations but one thing that is important to recognize is that a lot more work needs to be put into the care of people during this part of life.

India:

India has a very large population, second only to China. With health care improving and birthrates rising, the percentage of elderly individuals in the country is only going to get bigger. The numbers went form 20 million in 1951 to 70 million in 2009 and a projected 326 million in 2050 (United Nations, 1995). Although India is still very family based when it comes to the care of the elderly, new policies are being put in place to help support these rising numbers of aging individuals.

Two things that India's government has done in the last decade to address this situation are: In 2000, the government declared a National Older Person's Day to raise awareness and in May of 1999, the National Council of Older Persons was constituted. The NCOP has members from various political groups, such as the National Human Rights Commission, who gather together to advocate for the elderly and try to work out the problems. Health care has become more widely available and group homes are being provided due to more and more older people no longer being able to stay with their families like they once did. The government also feels very strongly about utilizing assets and funds training for those elderly individuals who want to have something to do in their retirement.

Non-Governmental Organizations also play their part in caring for the elderly. The NGO provides services for both the individual and their family. However, due to families being unable to afford the help, the NGO really only assists a very small percentage of the population.

Family is an aging person's support system. The family provides emotional, financial and social support. Culturally, the aging members of an Indian family are treated with respect and honored for their wisdom. As opposed to America, where only 15% of older people live with their children, India has close to 75%. There is a lot of pressure on the children to take in their parents, especially the male who have greater responsibility. The elderly also have very specific roles in a household: They take care of the children, resolve conflicts and help with matchmaking.
-Grace Maskell

England:



Health care for the elderly in England seems to be very similar to care for the elderly in the states. One of the main differences is that health care is free, due to the national health system in England. Everyone in England is taxed for health care, so there is no health insurance that needs to be payed, rather, health care is free for most people, particularly for the elderly and disabled. This enables elderly people to stay in their homes for longer, allowing home health workers and doctors to come to an elderly person's home, rather than that person or their family having to spend a lot of money on trips to the hospital.

There are still residential care facilities and nursing homes in England, but they are very expensive, (500 pounds a week, or $1000) This high cost has pressured the health service to continue to subsidize health care so the elderly can live in their homes for longer.

Below is a link to an article on this subject.

Another reason why people in England view keeping elderly home longer as a better option, is the poor treatment they receive in hospitals. A BBC report has confirmed that the elderly are being neglected on hospital wards, not consulted about their care, and treated like "second class citizens." One story in the article detailed the experience of a woman with Alzheimers who was in the hospital. She was on a ward that was not equipped to deal with people with dementia. The man writing this article said that he always had to make sure that a family member was with his mother, otherwise very important things got neglected. She had trouble eating, so if a family member wasn't with her, her meal tray would remain untouched. She would wake up in the middle of the night and wander around, so someone needed to be there to make sure she wasn't hurt. The two nights she was left alone she hit her head one night, and fractured her shoulder the other. The staff dismissed these concerns. When she was finally admitted to a nursing home, she had open sores on her back, was dehydrated and with a heavy cold. This story shows the type of horrible treatment an elderly person can face while in a hospital ward not equipped to deal with their concerns.
A link to the article is below.

In conclusion, health care for the elderly in England is very similar to that in the U.S., the one difference being universal health care provided by the NHS which puts an emphasis on favoring elderly people staying in their homes longer. There also seems to be more of a danger for neglect if an elderly person stays in the hospital, than if they were at home or in a nursing home.


-Sam Nelson

Questions:

1. In the past it was up to the family to take care of their aging parents but that seems to be changing. In your opinion do you think it should be the children's responsibility to care for the elderly?

2. Out of all the countries discussed, which one has the best plan for caring for the elderly. What should they work harder on and/or do differently?

America:

America, a country so rich in history, holds much power and authority all over the world. As one of the leading nations, we have redefined luxury and set forth high expectations for ourselves. We strive to remain one of the largest and most powerful countries in the world. Our government could be thought of as the “people” business, yet we lack one of the most critical components of the “people” business. To run a country, a successful country, it must begin within its citizens. Recent evidence provides we will be facing a major healthcare massacre, especially for elderly. Healthcare is a moral, civil rights, economic and human rights issue. Health is not a mere decision of what name brand of material goods to purchase at the local mall. Healthcare is a fundamental right to all people, and especially of all ages. Lifespan is prolonging considerably past the age of sixty, and retirement age will also be increasing as life expectancy increases. Since the elderly hold a higher rate of health issues, they often face age discrimination and their healthcare costs are often some of the highest. The united states department of human health and services. Medicare, the most primary form of heath care services established for the elderly of age 65 and older, yet it does not provide full coverage, and often the costs are not nearly close to what elderly receive in Social Security income. The Center for Disease control and prevention reports findings of the U.S. department of Health and Human Services, found the number of visits to physician offices by persons age 65 and over is 229.8 million. They also report that the access to health care percent of noninstitutionalized persons without a usual place of care age 65-74 is 3.8% and age 75 and over of 2.9%. Additional findings can be found on: http://www.cdc.gov/nchs/fastats/older_americans.htm
Out of the uninsured citizens in America, 7% were found uninsured out of the total population of 7% in a study conducted in 2005 by Office of the Assistant Secretary for Planning and Evaluation: http://aspe.hhs.gov/health/reports/05/uninsured-cps/index.htm

This is suggesting the increased need to provide health care to all, as many European countries have already established. Often, in many European and foreign cultures, the elderly are viewd as extended family members, often living with their children and grandchildren during old age, where as in America, elderly are often placed in very expensive nursing homes, and family members may visit only a handful of times during the month. This may also explain the high numbers of doctor patient visits.

Question:

President Barack Obama has proposed a new plan to transform and modernize Americas healthcare system, provide an example of one of his goals in this transformation, and discuss how this progressive change will effect the elderly.
You may refer to: http://www.healthreform.gov/ to support any ideas and provide findings.

-Sabina Medvinsky